Provider Demographics
NPI:1164639076
Name:BIRKMAIER, GEORGE
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:BIRKMAIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:GEORGE
Other - Middle Name:
Other - Last Name:BIRKMAIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:2015 LIBRARY CIR STE 102
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6387
Mailing Address - Country:US
Mailing Address - Phone:701-775-9791
Mailing Address - Fax:
Practice Address - Street 1:2015 LIBRARY CIR STE 102
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6387
Practice Address - Country:US
Practice Address - Phone:701-775-9791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2889183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist